Endobronchial tube with integrated image sensor

ABSTRACT

An endobronchial tube comprising at least two lumens of different lengths for selectively associating with a patient about at least two locations relative to the Tracheal Carina. said tube comprising: a first lumen having an open distal end that associates proximally to the Carina within the Trachea, with a first inflatable cuff; a second lumen having an open distal end that extends distally, past the Carina and associates within one of the Left Bronchial branch and Right Bronchial branch with a second inflatable cuff; a dedicated image sensor lumen spanning the length of said first lumen, the dedicated image sensor lumen comprising an image sensor and illumination source disposed adjacent to the distal end of said first lumen, and configured to provide an image of the Tracheal bifurcation of the Tracheal Carina, the openings of the Left Bronchial branch, and the opening Right Bronchial branch; and at least one dedicated cleaning lumen disposed parallel with said dedicated image sensor lumen along the length of said endobronchial tube and wherein said cleaning lumen is configured to forms a cleaning nozzle at the distal end, wherein said cleaning nozzle is directed toward said image sensor lumen at its distal end.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application is a Continuation of U.S. patent application Ser. No.14/967,048, filed on Dec. 11, 2015 and issued as U.S. Pat. No.10,245,402 on Apr. 2, 2019, which is a Continuation of U.S. patentapplication Ser. No. 13/819,743, filed on Feb. 28, 2013, which is aNational Stage Entry of International Application No. PCT/IB2012/052077,filed on Apr. 26, 2012, which claims the benefit of U.S. ProvisionalApplication No. 61/506,210, filed on Jul. 11, 2011. The presentapplication is related to U.S. patent application Ser. No. 15/042,163,filed on Feb. 12, 2016, which is a continuation-in-part of U.S. patentapplication Ser. No. 13/737,944, filed on Apr. 26, 2012, which is aNational Stage Entry of the aforementioned International Application No.PCT/IB2012/052077. The present application is also related to U.S.patent application Ser. No. 14/151,846, filed on Jan. 10, 2014 andissued as U.S. Pat. No. 10,245,402 on Dec. 11, 2018, which is acontinuation-in-part of the aforementioned U.S. patent application Ser.No. 13/737,944.

FIELD OF THE INVENTION

The present invention relates to upper airway tubes and in particular,to an endobronchial tube with an integrated image sensor and lightsource.

BACKGROUND OF THE INVENTION

Respiratory tubes for example endobronchial tubes, endotracheal tubes,tracheostomy tubes are used to ventilate at least a portion of therespiratory system or lungs of a subject. Such respiratory tubes may beinserted in a number of ways via a non-invasive approach through anorifice or cavity such as the oral or nasal cavity. Alternatively suchtubes may be introduced to a body via a minimally invasive externalincision creating a port for tube insertion for example through thetrachea in a tracheotomy procedure.

Such respiratory tubes may be provided as double lumen tubes, or singlelumen tubes for selectively ventilating a portion of the respiratorysystem. For example endobronchial tubes, whether, double lumen tubes ora single lumen tube may be utilized for one-lung ventilation proceduresor for selective lung ventilation of the left or right bronchi, duringone-lung ventilation procedures.

In order to perform one-lung ventilation procedures withoutcomplications, the position of the respiratory tube placed within eitherthe left or right bronchi and the trachea must be closely monitored orat least confirmed prior to initiating a procedure. Various technologiesare available to confirm the tube's placement, for example capnograph,auscultation, bronchoscope and x-ray.

However these procedures take time, technique and skill to perform andtherefore it is not feasible to continuously monitor the tube'splacement. In particularly when the subject is moved during a procedurethe tube's location may change leading to potentially dangerousdisplacement of the tube possibly suffocating the subject orinappropriate ventilation of the patient, for example not ventilatingthe correct portion of the respiratory system.

Verification by means of a bronchoscope is currently the gold standard,but none of the mentioned confirmation techniques provide continuousmonitoring of the carina or provide for correct tube positioning.Furthermore, drawbacks with respect to the design and sensitivity of thebronchoscope, render its cleaning process elaborate and ofteninefficient and costly process, that may lead to cross infection betweensubjects.

SUMMARY OF THE INVENTION

There is an unmet need for, and it would be highly useful to have anendobronchial tube capable of continuously and seamlessly inspect thelocation and implantation of the endobronchial tube relative to theTracheal Carina.

The present invention overcomes the deficiencies of the background byproviding an endobronchial tube having an integrated image sensor andcorresponding light source.

A preferred embodiment of the present invention provides for arespiratory tube, and an endobronchial tube, designed for oral or nasalinsertion via the trachea and into a lung to maintain airway patencyand/or deliver anesthetic, inhalation agent or other medical gases, andsecure ventilation.

Most preferably the endobronchial tube of the present invention may bemade of medical grade materials for example including but not limited toplastic, rubber, polymers or silicone or the like materials as is knownin the art.

Most preferably the endobronchial tube of the present invention providesfor continuous monitoring of the Tracheal Carina (herein “TC”), allowinga user, physician, nurse, or caregiver to verify the correct placementof the endobronchial tube

Most preferably the endobronchial tube includes an integrated imagesensor, optionally and preferably in the form of CCD or CMOS cameraprovided for visualizing the carina to confirm the correct placement ofthe tube within the trachea and bronchi, assuring correct ventilationduring procedures for example including but not limited to one lungventilation.

Most preferably the integrated camera and light source providecontinuous verification of the correct placement of the endobronchialtube. The continuous placement verification allows a caregiver theopportunity to detect any dangerous situation, for example cuffdislodgement, providing sufficient time to react to the situation as isnecessary. Moreover blood and secretion accumulation or any otherunexpected incidents during surgery, which might cause risk to thepatient, may be observed.

A preferred embodiment of the present invention provides for anendobronchial tube with an integrated image sensor, for exampleincluding but not limited to CCD or CMOS camera, with a correspondinglight source, for example including but not limited to a Light EmittingDiode (‘LED’) while optimizing the lumen patency for both adequateairflow performance through the tube. Most preferably the image sensorand corresponding light source are provided in a dedicated lumen alongthe length of the endobronchial tube. Most preferably the image sensoris further provided with a cleaning nozzle to ensure an open field ofview distal to the image sensor. Most preferably the length of thededicated image sensor lumen is provided paralleled with the length ofthe tracheal lumen, therein both tracheal lumen and image sensor lumenare of essentially the same length. Optionally the length of thededicated image sensor lumen may be provided according to the length ofthe bronchial lumen.

Optionally the endobronchial tube may be provided with two dedicatedimage sensor lumen. Optionally a first dedicated image sensor lumen isprovided according to the length of the tracheal lumen and a seconddedicated image sensor lumen is provided according to the length of thebronchial lumen.

A preferred embodiment of the present invention provides for anendobronchial tube with an integrated image sensor and light sourceprovide a continuously and unobstructed view and illumination of thecarina, left bronchi, right bronchi, bronchial cuff and bronchialbifurcations, within a single field of view.

An optional embodiment of the present invention provides for utilizingat least one or more bronchial cuff. Optionally at least two or morebronchial cuffs may be utilized to provide adequate sealing of thebronchi.

Optionally the bronchial cuff may be provided in varying shapes so as tobetter fit the bronchi for example include but is not limited tospherical, elliptical, helical, hourglass, trapezoidal, or the like.

Optionally different bronchial cuff configured and shaped according toanatomy and placement location, for example anatomy based onconfiguration of a cuff for left bronchi placement and for right bronchiplacement.

Within the context of this application the term endobronchial tube maybe used interchangeably with any one of Tracheobronchial tube, doublelumen tube, double lumen endobronchial tube, double lumen endotrachealtube, to collectively refer to a tube and/or catheter utilized forselectively ventilating a subject via both lungs, one of the lungs or aportion of one or both of the lungs.

An endobronchial tube comprising at least two lumen of different lengthsfor selectively associating with a patient about at least two locationsrelative to the Tracheal Carina, the tube comprising:

a. a first lumen having an open distal end that associates proximally tothe Carina within the Trachea, with a first inflatable cuff;

b. a second lumen having an open distal end that extends distally, pastthe Carina and associates within one of the Left Bronchial branch andRight Bronchial branch with a second inflatable cuff;

c. a dedicated image sensor lumen spanning the length of said firstlumen, the dedicated image sensor lumen comprising an image sensor andillumination source disposed adjacent to the distal end of said firstlumen, and configured to provide an image of the Tracheal bifurcation ofthe Tracheal Carina, the openings of the Left Bronchial branch, and theopening Right Bronchial branch; and

d. at least one dedicated cleaning lumen disposed parallel with saiddedicated image sensor lumen along the length of said endobronchial tubeand wherein said cleaning lumen is configured to forms a cleaning nozzleat the distal end, wherein said cleaning nozzle is directed toward saidimage sensor lumen at its distal end.

Optionally, said cleaning nozzle is provided with a diameter from 0.1 mmto 2.0 mm.

Optionally, said cleaning nozzle is provided with a diameter of 0.6 mm.

Optionally, said cleaning lumen is provided with two or more cleaningnozzles about either side of said image sensor.

Optionally, said two or more cleaning nozzles cooperate with oneanother.

Optionally, said cleaning lumen provides for suctioning or flushing theimage sensor field of view.

Optionally, said dedicated image sensor lumen is disposed within thewall of said tube about an anterior or posterior portion between saidfirst and second lumen.

Optionally, the second lumen comprises a second image sensor providingan image of the Right bronchi or Left bronchi.

Optionally the image sensor may be a CCD image sensor or CMOS imagesensor.

Optionally, the first lumen further comprises a light source disposedproximal to the distal end of said first lumen and adjacent to the imagesensor.

Optionally, the light source may be selected from the group consistingof a LED, optical fiber, waveguide, light guide, and any combinationthereof.

Optionally the image sensor may be disposed within a dedicated channelembedded within a wall of the first lumen.

Most preferably the image sensor may be associated with an auxiliarydevice for example including but not limited to a display and powersupply at the proximal end of the tube most preferably about the firstlumen, through a single dedicated connector for example including butnot limited to a USB connector.

Optionally the endotracheal tube may be adapted for non-invasiveinsertion through the oral cavity or nasal cavity.

Optionally the endotracheal tube may be adapted for insertion through anexternal port or incision.

Optionally the endotracheal tube may be adapted for insertion through asurgical procedure or other invasive procedure.

Unless otherwise defined, all technical and scientific terms used hereinhave the same meaning as commonly understood by one of ordinary skill inthe art to which this invention belongs. The materials, methods, andexamples provided herein are illustrative only and not intended to belimiting.

BRIEF DESCRIPTION OF THE DRAWINGS

The invention is herein described, by way of example only, withreference to the accompanying drawings. With specific reference now tothe drawings in detail, it is stressed that the particulars shown are byway of example and for purposes of illustrative discussion of thepreferred embodiments of the present invention only, and are presentedin order to provide what is believed to be the most useful and readilyunderstood description of the principles and conceptual aspects of theinvention. In this regard, no attempt is made to show structural detailsof the invention in more detail than is necessary for a fundamentalunderstanding of the invention, the description taken with the drawingsmaking apparent to those skilled in the art how the several forms of theinvention may be embodied in practice.

In the drawings:

FIGS. 1A-B show schematic illustrations of an exemplary endobronchialtube according to an optional embodiment of the present invention; FIG.1A shows the endobronchial tube within the right bronchi; and FIG. 1Bshows the endobronchial tube within the left bronchi;

FIG. 2 shows a schematic sectional view of the Tracheal Carina as seenfrom the endobronchial tube according to an optional embodiment of thepresent invention;

FIG. 3 shows a perspective views of an exemplary endobronchial tubeaccording to an optional embodiment of the present invention;

FIG. 4A shows a perspective view of an exemplary endobronchial tubeaccording to an optional embodiment of the present invention;

FIG. 4B shows a close up view of notch exit point for the image sensorconnector according to the present invention;

FIG. 5 shows a perspective view of exemplary endobronchial tubeaccording to an optional embodiment of the present invention;

FIG. 6 shows a perspective view of exemplary endobronchial tubeaccording to an optional embodiment of the present invention, depictingthe curvature of the tube;

FIGS. 7A-F show varying close up views of the distal end of theendobronchial tube according to optional embodiments of the presentinvention;

FIGS. 8A-B show cross-sectional views about different portions of theendobronchial tube according to optional embodiments of the presentinvention; and

FIG. 9 shows a close up view of the image sensor with integrated lightsource within a dedicated lumen disposed within the wall of theendobronchial tube according to an optional embodiment of the presentinvention.

DESCRIPTION OF THE PREFERRED EMBODIMENTS

The principles and operation of the present invention may be betterunderstood with reference to the drawings and the accompanyingdescription. The following reference labels listed below are usedthroughout the drawings to refer to objects having similar function,meaning, role, or objective.

-   -   10 Stylet;    -   12 Y-connector;    -   14 Air Balance Cap;    -   20 Endobronchial Tube connector assembly;    -   22 Endobronchial Tube connector proximal end;    -   24 Tracheal lumen connector portion;    -   26 Bronchial lumen connector portion;    -   28 Endobronchial Tube connector distal end;    -   50 endobronchial tube system;    -   100 endobronchial tube;    -   101 sectional view;    -   102 tube proximal end;    -   104 tube distal end;    -   104 a distal curvature;    -   106 tube medial portion;    -   106 a medial curvature;    -   108 midline partition;    -   110 tracheal lumen;    -   111 tracheal lumen connector;    -   112 tracheal cuff;    -   112 n tracheal cuff notch;    -   114 tracheal lumen distal end;    -   116 tracheal lumen proximal end;    -   118 tracheal cuff connector;    -   120 bronchial lumen;    -   122 bronchial cuff;    -   124 bronchial lumen distal end;    -   126 bronchial lumen proximal end;    -   128 bronchial cuff connector;    -   130 injection tube connector;    -   150 image sensor with integrated illumination;    -   150C image sensor;    -   1501 illumination source;    -   150L image sensor lumen    -   152 image sensor notch;    -   154 image sensor conductor;    -   156 image sensor cleaning nozzle;    -   158 image sensor connector;    -   160 cleaning lumen;    -   TR Trachea;    -   TC Tracheal Carina;    -   BR Right Bronchi;    -   BL Left Bronchi.

FIG. 1A shows a schematic illustration of an exemplary endobronchialtube 100 according to an optional embodiment of the present invention,placed within the right bronchi (BR). FIG. 1B shows a schematicillustration of an endobronchial tube 100 within the left bronchi (LB).

Endobronchial tube 100 is a dual lumen tube comprising a first tracheallumen 110 and a second bronchial lumen 120. Most preferably a midlinepartition 108 defines the individual lumen into tracheal lumen 110 andbronchial lumen 120. Tracheal lumen 110, most preferably, ends withinthe trachea while the bronchial lumen 120 ends within the bronchi, leftor right. Therein tracheal lumen 110 and bronchial lumen 120 areconfigured to have different lengths, wherein the bronchial lumen 120extends past and/or distally to tracheal lumen 110.

Each lumen comprises an inflatable cuff respectively, tracheal cuff 112and bronchial cuff 122. Endobronchial tube 100 is placed such thattracheal lumen 110 is placed within the Trachea by way of cuff 112proximally, above, the tracheal carina. Most preferably the trachealcarina may be continually visualized with an image sensor andillumination source 150, also referred to as integrated image sensor150. Optionally image sensor and illumination source 150 may beintegrated within tracheal lumen 110 about its distal end 114.Optionally and most preferably image sensor and illumination source 150may be integrated within a dedicated channel or peripheral lumen 150L,also referred to as image sensor lumen 150L, within a wall of thetracheal lumen 110. Most preferably image sensor 150C provides a crosssectional view 101, shown in FIG. 2.

Most preferably image sensor and illumination source 150 is provided inthe form of at least one or more light emitting diode (‘LED’) 1501 andimage sensor 150C, for example including but not limited to a CCD orCMOS, (FIG. 9) providing a view 101 showing the status of the bronchi,FIG. 2.

FIG. 2 shows a schematic sectional view of the Tracheal Carina as seenfrom endobronchial tube 100, provided by image sensor and illuminationsource 150, allowing the visualization of bronchial cuff 122 disposedwithin the left bronchi BL, the patency of the left bronchi, the patencyof the right bronchi, the tracheal carina, bronchial bifurcation, in asingle field of view 101. Optionally a similar view may be provided withintegrated image sensor 150 when endobronchial tube 100 is disposed withthe right Bronchi BR as shown in FIG. 1A.

FIG. 3 shows endobronchial double lumen tube system 50 comprisingendobronchial tube 100 and optional various auxiliary devices that maybe used in conjunction with and/or facilitate the use of endobronchialtube 100.

Optionally auxiliary devices may, for example, include but are notlimited to stylet 10, Y-connector 12, air balance caps 14, and anendobronchial tube connector assembly 20, or the like adjunct deviceutilized facilitating the use of endobronchial tube 100 as is known inthe art.

Stylet 10 most preferably is utilized to facilitate placement ofendobronchial tube 100, as is known and accepted in the art.

Y-connector 12 most preferably provides for simultaneously connectingboth lumens of double lumen tube 100 to a single ventilation source.

Endobronchial Tube connector assembly 20 provides for individuallyconnecting to tracheal lumen 110 and bronchial lumen 120. Connector isassembly 20 comprises a proximal end 22, distal end 28, and respectivetracheal lumen connector portion 24 and Bronchial connector portion 26.

Most preferably proximal end 22 provides for connecting and/or otherwiseassociating endobronchial tube 100 at proximal end 102 at about theindividual lumen tracheal lumen 110 and bronchial lumen 120 to auxiliarydevices for example including but not limited to ventilation sources.

Most preferably distal end 24 provides for coupling and/or otherwiseassociating with endobronchial tube 100.

FIG. 3 further provides a perspective view of a preferred double lumenendobronchial tube 100 comprising tracheal lumen 110 having a tracheallumen distal end 114 and bronchial lumen 120 having a bronchial lumendistal end 124. Also shown in FIG. 3 are a tube proximal end 102, a tubemedial portion 106, and a tube distal end 104 of a tube 140 (FIGS. 8Aand 8B) of endobronchial tube 100, which are also the proximal end,medial portion, and distal end of endobronchial tube 100.

Endobronchial tube 100 further comprises tracheal cuff 112, shown in itsexpanded state, provided for securely placing and/or anchoringendobronchial tube 100 within the trachea while ventilating the lungsthrough tracheal lumen 110. Tracheal cuff 112 is supported by tube 140.

Tube 100 further comprises bronchial cuff 122, shown in its expandedand/or inflated state, provided for securely placing and/or anchoringendobronchial tube 100 within the bronchi, left or right. Mostpreferably cuff 122 provides for selectively controlling the ventilationto the bronchial arch wherein it is placed (left or right). For exampleventilation to either the left or right bronchi may be completelyblocked so as to allow a procedure on the respective lung (for exampleright) while allowing the ventilation of the other lung (for exampleleft) via tracheal lumen 110. Broncheal cuff 122 is supported by tube140.

Most preferably tracheal cuff 112 may be inflated and/or deflated viacuff tracheal connector 118.

Most preferably bronchial cuff 122 may be inflated and/or deflated viacuff bronchial connector 128.

Most preferably injection tube connector 130 provides an access point toa dedicated lumen about each of the tracheal lumen 110 and bronchialtube 120, preferably for delivering drugs, suctioning liquids abouttracheal distal 114 and/or bronchial lumen distal end 124.

FIG. 4A provide a further perspective view of endobronchial tube 100,showing image sensor connector 158. Most preferably image sensorconnector 158 is provided in the form of a USB connector that providesboth for image and power supply to image sensor 150 disposed in adedicated lumen near distal end 114. Optionally and preferably imagesensor and illumination source 150 may be rendered function whenconnected to a display and power source (not shown) via connector 158.

FIG. 4B provides a close up view showing the image sensor notch 152disposed about the proximal end of image sensor lumen 150L providing anexit point for image sensor conducting wires 154, most preferablyprovided for both image transfer and power supply to image sensor andillumination source 150.

FIG. 5 provides a further perspective view of endobronchial tube 100provided from a face on view showing the separation of tracheal lumen110 and bronchial lumen 120 at distal end 104 of endobronchial tube 100.

FIG. 6 provides a further schematic illustrative depiction ofendobronchial tube 100 showing a perspective view of endobronchial tube100 with bronchial cuff 122 and tracheal cuff 112 removed. FIG. 6A showsthe curvature provided at both medial section 106 and distal end 104therein defining a medial curvature 106 a and a distal curvature 104 a.Curvatures 104 a and 106 a are provided to so that endobronchial tube100 fits within the upper airway tract's anatomy.

Most preferably medial curvature 106 a is provided for the ease ofaccessing and introducing tube 100 within the trachea through the oralcavity and pharynx. Most preferably, curvature 106 a is provided with anangle from about 100 degrees to about 160 degrees.

Most preferably distal curvature 104 a is proved for ease of accessingand introducing distal end 104 into one of the bronchi, left or right.Optionally and preferably distal curvature 104 a may be specific forindividual left or right endobronchial tubes. Optionally distalcurvature may be configured to be from about 25 degrees to about 70degrees. Optionally and preferably about 35 degrees as shown.

Optionally the length of endobronchial tube 100 may be provided with alength from about 200 mm to about 550 mm. Optionally and preferably thelength of tube 100 may be selected in accordance with a user's anatomy.

Optionally endobronchial tube 100 may be provided with different sizes,length, diameters as known and accepted in the art. Optionallyendobronchial tube 100 may be provided with a gauge from about 26 Fr toabout 44 Fr, or from about, for example, the external diameter of tube140 may be provided in varying gauges and/or sizes for example includingbut not limited to 28 Fr, 32 Fr, 35 Fr, 37 Fr, 39 Fr and 41 Fr, withinthe context of this application the units ‘Fr’ refer to the gauge of thetube 140 in the units French as is a common term of the art.Alternatively the gauge and or size of tube 140 may be provided in theSI units of millimeters ‘mm’. Tube 140 according to the presentinvention may be provided with an external diameter of about 9.3 mm,10.7 mm, 11.7 mm, 13 mm and 13.7 mm.

Optionally and preferably the length and diameter (also referred to asgauge) of tube 100 may be correlated with one another.

FIG. 7A shows a close up view of distal end 104 of endotracheal tube 100shown in FIG. 6 providing a close up view. FIG. 7A further shows a closeup view of curvature 104 a showing the flaring of distal end 104 fromthe tracheal lumen into the side portion of bronchial lumen 120.

FIGS. 7A-E show various close up view of distal end 104 specific tocurvature 104 a showing the flaring and tapering of distal end 104 fromthe tracheal lumen into the side portion of bronchial lumen 120.

FIGS. 7D-E provide further close up views of the distal end of imagesensor lumen 150L and cleaning nozzle 156, most preferably provided forcleaning image sensor. Optionally and preferably cleaning nozzle 156 isprovided with an opening having a diameter from about 0.1 mm to about2.0 mm. Optionally and preferably cleaning nozzle 156 may be providedwith a diameter of about 0.6 mm.

Image sensor 150 is most preferably provided in a dedicated image sensorlumen 150L that spans the length of endobronchial tube 100. Mostpreferably image sensor lumen 150L is disposed between tracheal lumen110 and bronchial lumen 120.

Most preferably distal end of image sensor lumen 150L provides forvisualizing the carina and bronchial cuff 122, for example as shown inFIG. 2.

Most preferably the diameter of image sensor lumen 150L is variablealong the length of endobronchial tube 100. Most preferably image sensorlumen 150 is smallest at the proximal end 102 and largest at the distalend 104. Optionally and preferably at proximal end 102 image sensorlumen 150L is configured to have an elliptical cross-section. Optionallyand preferably at distal end of image sensor lumen 150L is configured tohave a circular cross-section.

Most preferably alongside image sensor lumen 150L is a dedicatedcleaning lumen 160 that has a distal end defining a cleaning nozzle 156,as shown, providing for cleaning integrated image sensor 150 about itsdistal end. Optionally and preferably cleaning nozzle 156 is providedwith a curvature and/or angle so as to direct cleaning solution, fluid,gas or the like flowing fluid toward and/or away from integrated imagesensor 150 and more preferably image sensor 150C. For example cleaninglumen 160 may be utilized to clear mucus or the like biologicalobstruction from in front of integrated image sensor 150 by flushingwith a flowing fluid, for example a liquid or gas, from the proximal endof lumen 160 through to its distal end at forming cleaning nozzle 156.Optionally cleaning lumen 160 may be used to clear the viewing field ofintegrated image sensor 150 by applying suctioning therein suctioning infront of the field of view to keep it clean.

FIG. 7F shows a close up view of cleaning nozzle 156 as directed towardimage sensor 150C about the distal end of image sensor lumen 150L.Optionally and preferably cleaning nozzle 156 is configured such that itprovides for maintaining an open field of view of the Tracheal Carinafor integrated image sensor 150.

Optionally and preferably the distal end of cleaning lumen 160 may becurved such that the distal end is directed toward the distal end ofimage sensor lumen 150L therein providing for forming at least one ormore cleaning nozzle 156 that is optionally and preferably directedtoward image sensor 150C, for example as shown in FIG. 7E.

Optionally endobronchial tube 100 may be provided with at least two ormore cleaning lumen 160. Optionally a first cleaning lumen may beprovided for flushing biological obstruction while a second cleaninglumen may be provided for suctioning biological obstructions away fromthe distal end 114. Optionally a plurality of cleaning lumen 160 may bedisposed on opposite sides of integrated image sensor 150. Optionally aplurality of cleaning lumen 160 may be configured to cooperate with oneanother, for example a first lumen would flush biological obstructionstoward a dsecond cleaning lumen where the obstruction is carried away bysuctioning. Optionally at least two or more cleaning lumen may beutilized concertedly to either suction or flush obstructions distal tointegrated image sensors 150, therein most preferably ensuring an openviewing field. Optionally a plurality of cleaning lumen may be providedwith different diameters and or sizes.

FIG. 8A shows a cross sectional view of tube 140 of endobronchial tube100 about its proximal end 102 having tracheal lumen 110 and a bronchiallumen 120 defined on either side of a midline partition 108. Tube 140comprises an exterior surface 142 and interior surfaces 144, 146 of,respectively, tracheal lumen 110 and bronchial lumen 120. Mostpreferably tube 140 of endobronchial tube 100 comprises a plurality ofperipheral lumen disposed internally and/or within the walls ofendobronchial tube 100. Most preferably a plurality of peripheral lumenmay be disposed about the circumference of tube 140 and span essentiallythe length of tube 140, about the tracheal lumen 110 and/or bronchiallumen 120. Optionally and preferably the peripheral lumen may forexample include but is not limited to a suctioning lumen, cuff inflatinglumen, electronic lumen, image sensor lumen, cleaning lumen, injectiontube lumen, or the like.

Most preferably endobronchial tube 100 includes a dedicated image sensorlumen 150L provided for image sensor and integrated illumination source150. Most preferably image sensor lumen 150L provides for housingintegrated image sensor 150 at its distal end (FIG. 7E-F) and housingimage sensor conductors 154, for example in the form of a wire, disposedalong the length of image sensor lumen 150L, and a image sensor notch152 disposed near the proximal end of image sensor lumen 150L allowingimage sensor conductors 154 and connector 158 to be disposed external toendobronchial tube 100.

Optionally and preferably image sensor lumen 150L is disposed about theanterior portion of endobronchial tube 100 about the middle of thecross-section of endobronchial tube 100. Most preferably image sensorlumen 150L is disposed anterior to partition 108. Optionally imagesensor lumen 150L may be disposed about the posterior portion ofendotracheal tube 100 therein posterior to partition 108.

Most preferably on both sides of image sensor lumen 150L are dedicatedlumen running along the length of endobronchial tube 100 and mostpreferably running parallel with image sensor lumen 150L. Optionally andpreferably at least one or more of lumen are provided as a dedicatedcleaning lumen 160. Optionally both lumen flanking image sensor lumen150L may be dedicated cleaning lumen 160.

Most preferably the tube wall further comprises inflation lumens 112Land 122L respectively corresponding to tracheal lumen 110 and bronchiallumen 120. Optionally and preferably lumen 112L and 122L are providedfor inflating and/or deflating cuffs 112 and 122, respectively.

FIG. 8B shows the same image as in FIG. 8A however showing thecross-section near tracheal lumen distal end 114 of endobronchial tube100. Most preferably at tracheal lumen distal end 114 image sensor lumen150L is provided with a lumen having a larger radius than that providedat the proximal end 102 as shown in FIG. 8A. Most preferablyendobronchial tube 100 is expanded about distal end 104 and lumen 150Lto accommodate integrated image sensor 150. Optionally image sensorlumen 150 about the external surface of tube 110 is widened and/orexpanded 1.5 mm to 5 mm from distal end 114 of tracheal lumen 110.

Optionally the image sensor dedicated lumen 150L is provided with annotch 150 n disposed 22.5 mm from the proximal end 102 of endobronchialtube 100 and an exit notch having a diameter of about 1.5 mm.

FIG. 9 shows a close up bottom-up view of the integrated image sensor150 within dedicated image sensor lumen 150L disposed within the wall ofendobronchial tube 100, showing image sensor 150C optionally andpreferably provided in the form of a CCD or CMOS or the like, andillumination source 1501 most preferably provided in the form of atleast one and more preferably at least two or more LED, as shown.

While the invention has been illustrated primarily with reference to aleft bronchi endobronchial tube, it will be appreciated that the presentinvention is not limited to a left bronchi endobronchial tube where theinventive and novel aspects equally covers a right bronchi endobronchialtube.

While the invention has been described with respect to a limited numberof embodiments, it will be appreciated that many variations,modifications and other applications of the invention may be made.

What is claimed is:
 1. An endobronchial tube comprising at least twolumens of different lengths for selectively associating with a patientabout at least two locations relative to the Tracheal Carina, said tubecomprising: a. a first lumen having an open distal end adapted toassociate proximally to the Carina within the Trachea, with a firstinflatable cuff; b. a second lumen having an open distal end adapted toextend distally, past the Carina and associate within one of the LeftBronchial branch and Right Bronchial branch with a second inflatablecuff; c. a dedicated image sensor lumen spanning the length of saidfirst lumen, located within a wall of said tube between said first lumenand said second lumen, the dedicated image sensor lumen comprising animage sensor and illumination source disposed adjacent the distal end ofsaid first lumen, and configured to provide an image of the Trachealbifurcation of the Tracheal Carina, the openings of the Left Bronchialbranch, and the opening Right Bronchial branch; and d. at least onededicated cleaning lumen disposed parallel with said dedicated imagesensor lumen along the length of said endobronchial tube, disposedwithin said wall of said tube between said first lumen and said secondlumen, and wherein said cleaning lumen curves at the distal end to forma cleaning nozzle, such that the distal end of said cleaning lumen isdirected toward the distal end of said image sensor lumen.
 2. The tubeof claim 1, wherein said cleaning nozzle is provided with a diameterfrom 0.1 mm to 2 mm.
 3. The tube of claim 2, wherein said cleaningnozzle is provided with a diameter of 0.6 mm.
 4. The tube of claim 1,wherein said cleaning lumen is provided with two or more cleaningnozzles about either side of said image sensor.
 5. The tube of claim 4,wherein said two or more cleaning nozzles cooperate with one another. 6.The tube of claim 1, wherein said cleaning lumen provides for suctioningor flushing the image sensor field of view.
 7. The tube of claim 1,wherein said dedicated image sensor lumen is disposed within the wall ofsaid tube about an anterior or posterior portion between said first andsecond lumen.
 8. The endobronchial tube of claim 1, wherein said secondlumen comprises a second image sensor providing an image of the Rightbronchi or Left bronchi.
 9. The endobronchial tube of claim 1, whereinsaid image sensor is a CCD image sensor or CMOS image sensor.
 10. Theendobronchial tube of claim 1, wherein said light source is selectedfrom the group consisting of a LED, optical fibre, waveguide, lightguide, and any combination thereof.
 11. The endobronchial tube of claim1, adapted for non-invasive insertion through the oral cavity or nasalcavity.
 12. The endobronchial tube of claim 1, adapted for insertionthrough an external port or incision.
 13. The endobronchial tube ofclaim 1, adapted for insertion through surgery or other invasiveprocedure.